Music Box Foundation Registration
Every Saturday, 1:30 - 3:30 PM Contact Us: 773-363-4844 or info@musicboxfoundation.org
Select Your Session
Fall 2024 - (October 5 - December 7)
Winter 2025 - (January 18 - March 8)
Spring 2025 - (April 5 - May 24)
Participant Name
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Non-Binary
Birthdate
*
-
Month
-
Day
Year
Date
Select Your Instrument
*
Please Select
Brass/Coronet
Clarinet
Drums/Percussion
Flute
Guitar
Piano
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Parent/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Terms & Agreements
I and/or my children agree to abide by the program rules, and may be asked to leave class if disruptive behavior is exhibited. Acts of violence will not be tolerated as it is a direct violation of Music Box Foundation's Code of Conduct. Such behavior may result in the the immediate dismal from the program.
I agree
I hereby give permission to Music Box Foundation for use of any photos, audio, and/or video in which my child(ren) may appear. The usage is inclusive of, but not limited to, the publication or inclusion in brochures, posters, catalogs, handbooks, banners, websites, and broadcast or print advertisements. I agree to waive any claim to compensation for use of said photos.
I agree
Attendance is crucial to success. I understand that consistent attendance at the session is crucial to the program’s success, and will make every effort to insure the participant is present for all class meetings and scheduled performances. In the event that my child(ren) is unable to attend a class or must leave early, I agree to inform Music Box Foundation with as much advance notice as possible. I understand that failure to attend class consistently, the participant may be dismissed from the program or ineligible to play in the final performance. I have read and agreed to all the information contained in this agreement. I agree to allow my information to be used in aggregate for reporting and analysis on this program.
I agree
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Submit Your Payment
*
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Deposit
Secures your place in the upcoming class
$
25.00
Quantity
1
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New Registration
Payment Plans Available
$
100.00
Quantity
1
2
3
4
5
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7
8
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10
Returning Registration
Payment Plans Available
$
60.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
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